Angela Dawn Andrus, MPT
Individual provider Active NPI Physical Therapist · Idaho Falls, ID
NPI 1386802908 · NPPES record last updated May 30, 2008
Key facts
- NPI
- 1386802908
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapist 225100000X
- License
- PT1085 (ID)
- Practice address
- 2030 Jennie Lee Dr
Suite a
Idaho Falls, ID 83404-7000 - Phone
- (208) 523-8879
- Fax
- (208) 523-0436
- NPI assigned
- May 30, 2008
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PT1085 | ID | MD | Physical Therapist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | PT1085 | ID | Yes |
| Pediatric Physical Therapist | 2251P0200X | PT1085 | ID |
Addresses
Primary practice location
2030 Jennie Lee Dr
Suite a
Idaho Falls, ID 83404-7000
Mailing address
611 Cedar Ridge Dr
Idaho Falls, ID 83404-7278
Phone (208) 523-6052
Other providers in Idaho Falls, ID
- Russell Anderson
- Taylor K Anderson
- Whitney C Anderson
- Andre'S House
- Andrew L McCall DPM PA
- Shanda Andrus
- Angel Wings Center of Healing
- Angel Wings Center of Healing
- Marisol Ramirez Angeles
- Frank R Angelo
All providers in Idaho Falls, ID · Physical Therapist in Idaho
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 30, 2008. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.